Schizophrenia and autism spectrum disorder (ASD) are currently conceptualized as distinct disorders. However, the relationship between these two disorders has been revisited in recent years due to evidence that they share phenotypic and genotypic expressions. This study aimed to identify ASD traits in patients with schizophrenia, and to define their demographic, psychopathological, cognitive and functional correlates.Seventy-five schizophrenia patients (20 females, mean age 42 ± 12) were evaluated with the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R). Participants were also assessed with clinical, neuropsychological, and psychosocial functioning measures.Of the 75 patients, 47 were negative to all the autism scales administered (ADOS-TOT-NEG), 21 patients were positive to the ADOS Language sub-domain (ADOS-L-POS), 21 patients were positive to the ADOS Reciprocal Social Interaction (RSI) sub-domain (ADOS-RSI-POS), 14 patients were positive to the ADOS Total scale (ADOS-TOT-POS), and nine patients were positive to the ADI-R scale (ADI-R-POS). Demographic (duration of illness), psychopathological (negative symptoms and general psychopathology), and cognitive (working memory and processing speed) differences emerged between schizophrenic patients with and without ASD traits, while no differences in psychosocial functioning were detected. Results of this study indicate the existence, in a sample of patients with a diagnosis of schizophrenia, of a distinct group of subjects with ASD features, characterized by specific symptomatological and cognitive profile.These findings may contribute to better characterize patients with schizophrenia in order to develop new procedures and therapeutic tools in a more personalized perspective.

Females in the general population on average have a stronger drive to empathize, and males in the general population on average have a stronger drive to systemize. Evidence related to these claims is reviewed. People with autism spectrum conditions have below average empathy alongside intact or even above average interest in systems. As such, they can be conceptualized as an extreme of the typical male brain.Copyright © 2010 Elsevier B.V. All rights reserved.

In 1997 in this Journal we published the "Reading the Mind in the Eyes" Test, as a measure of adult "mentalising". Whilst that test succeeded in discriminating a group of adults with Asperger syndrome (AS) or high-functioning autism (HFA) from controls, it suffered from several psychometric problems. In this paper these limitations are rectified by revising the test. The Revised Eyes Test was administered to a group of adults with AS or HFA (N = 15) and again discriminated these from a large number of normal controls (N = 239) drawn from different samples. In both the clinical and control groups the Eyes Test was inversely correlated with the Autism Spectrum Quotient (the AQ), a measure of autistic traits in adults of normal intelligence. The Revised Eyes Test has improved power to detect subtle individual differences in social sensitivity.

Currently there are no brief, self-administered instruments for measuring the degree to which an adult with normal intelligence has the traits associated with the autistic spectrum. In this paper, we report on a new instrument to assess this: the Autism-Spectrum Quotient (AQ). Individuals score in the range 0-50. Four groups of subjects were assessed: Group 1: 58 adults with Asperger syndrome (AS) or high-functioning autism (HFA); Group 2: 174 randomly selected controls. Group 3: 840 students in Cambridge University; and Group 4: 16 winners of the UK Mathematics Olympiad. The adults with AS/HFA had a mean AQ score of 35.8 (SD = 6.5), significantly higher than Group 2 controls (M = 16.4, SD = 6.3). 80% of the adults with AS/HFA scored 32+, versus 2% of controls. Among the controls, men scored slightly but significantly higher than women. No women scored extremely highly (AQ score 34+) whereas 4% of men did so. Twice as many men (40%) as women (21%) scored at intermediate levels (AQ score 20+). Among the AS/HFA group, male and female scores did not differ significantly. The students in Cambridge University did not differ from the randomly selected control group, but scientists (including mathematicians) scored significantly higher than both humanities and social sciences students, confirming an earlier study that autistic conditions are associated with scientific skills. Within the sciences, mathematicians scored highest. This was replicated in Group 4, the Mathematics Olympiad winners scoring significantly higher than the male Cambridge humanities students. 6% of the student sample scored 32+ on the AQ. On interview, 11 out of 11 of these met three or more DSM-IV criteria for AS/HFA, and all were studying sciences/mathematics, and 7 of the 11 met threshold on these criteria. Test-retest and interrater reliability of the AQ was good. The AQ is thus a valuable instrument for rapidly quantifying where any given individual is situated on the continuum from autism to normality. Its potential for screening for autism spectrum conditions in adults of normal intelligence remains to be fully explored.

To determine how opiate receptor distribution is co-localized with the distribution of nociceptive areas in the human brain, eleven male healthy volunteers underwent one PET scan with the subtype-nonselective opioidergic radioligand [(18)F]fluoroethyl-diprenorphine under resting conditions. The binding potential (BP), a parameter for the regional cerebral opioid receptor availability, was computed using the occipital cortex as reference region. The following regions of interest (ROIs) were defined on individual MR images: thalamus, sensory motor strip (SI/MI area), frontal operculum, parietal operculum, anterior insular cortex, posterior insular cortex, anterior cingulate cortex (ACC; peri- and subgenual part of "classical ACC" only), midcingulate cortex (MCC, posterior part of "classical ACC"), putamen, caudate nucleus and the amygdala. BP for [(18)F]fluoroethyl-diprenorphine was lowest in the sensory motor strip (0.30). Highest BP was found in thalamus (1.36), basal ganglia (putamen 1.22, caudate 1.16) and amygdala (1.21). In the cingulate cortex, ACC (1.11) had higher BP than MCC (0.86). In the operculo-insular region, we found high BPs in all ROIs: anterior insula (1.16), posterior insula (1.05), frontal operculum (0.99) and parietal operculum (0.77). Factor analysis of interindividual variability of opiate receptor BP revealed four factors (95% explained variance): (1) operculo-insular areas, ACC, MCC and putamen, (2) amygdala and thalamus, (3) caudate and thalamus, (4) SI/MI and MCC. Nociceptive areas of the lateral pain system (frontoparietal operculum and insula) have opiate receptor BPs significantly higher than SI/MI, comparable to anterior and midcingulate areas of the medial pain system. These findings suggest that the cortical anti-nociceptive effects of opiates are not only mediated by ACC and MCC, but also by the operculo-insular cortex, if it can be assumed that opioid binding mediates anti-nociception in those structures.

Parents' perceptions of their children's emotional expressiveness, and possible bases for these perceptions, were investigated in a study comparing older, nonretarded autistic and normal children and in another study comparing young autistic, mentally retarded, and normal children. Both groups of autistic children were perceived as showing more negative emotion and less positive emotion than comparison children. In the younger sample, parental perceptions correlated with the children's attention and responsiveness to others' displays of emotion in 2 laboratory situations. Findings contradict the view that autism involves the "absence of emotional reaction" (American Psychiatric Association, 1987, p. 35).

Lack of empathy is one of the behavioral hallmarks in individuals with autism spectrum conditions (ASC) as well as youth with conduct disorder symptoms (CDS). Previous research has reliably documented considerable overlap between the perception of others' pain and first-hand experience of pain. However, the linkage between empathy for pain and sensitivity to physical pain needs to be empirically determined, particularly in individuals with empathy deficits. This study measured the pressure pain threshold, which indexes sensitization of peripheral nociceptors, and assessed subjective ratings of unpleasantness and pain intensity in response to empathy-eliciting stimuli depicting physical bodily injuries in three age- and sex-matched participant groups: ASC, CDS, and typically developing controls (TDC). The results indicated that the pain threshold was lowest in the ASC group and highest in the CDS group. The ASC group displayed lower ratings of unpleasantness and pain intensity than did the TDC and CDS groups. Within the ASC and CDS, pain intensity ratings were significantly correlated with unpleasantness ratings to others' pain. Moreover, the ASC significantly differed from the TDC in the correlation between pain threshold values and unpleasantness ratings. These findings may cast some light on the linkage between atypical low-level sensory functioning, for instance altered pain sensitivity, and high-level empathic processing. Autism Res 2017, 10: 267-275. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.© 2016 International Society for Autism Research, Wiley Periodicals, Inc.

Empathic arousal is the first ontogenetic building block of empathy to appear during infancy and early childhood. As development progresses, empathic arousal becomes associated with an increasing ability to differentiate between self and other, which is a critical aspect of mature empathetic ability (Decety and Jackson, 2004). This allows for better regulation of contagious distress and understanding others mental states. In the current study, we recorded electroencephalographic event-related potentials and mu suppression induced by short visual animations that depicted painful situations in 57 typically developing children aged between 3 and 9 years as well as 15 young adults. Results indicate that the difference wave of an early automatic component (N200), indexing empathic arousal, showed an age-related decrease in amplitude. In contrast, the difference wave of late-positive potentials (LPP), associated with cognitive appraisal, showed an age-related gain. Only early LPP was detected in children, whereas both early and late LPP were observed in adults. Furthermore, as compared with adults, children showed stronger mu suppression when viewing both painful and non-painful stimuli. These findings provide neurophysiological support for the development of empathy during childhood, as indicated by a gradual decrease in emotional arousal and an increase in cognitive appraisal with age. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Identification of other people's emotion from quickly presented stimuli, including facial expressions, is fundamental to many social processes, including rapid mimicry and empathy. This study examined extraction of valence from brief emotional expressions in adults with autism spectrum disorder (ASD), a condition characterized by impairments in understanding and sharing of emotions. Control participants were individuals with reading disability and typical individuals. Participants were shown images for durations in the range of microexpressions (15 ms and 30 ms), thus reducing the reliance on higher level cognitive skills. Participants detected whether (a) emotional faces were happy or angry, (b) neutral faces were male or female, and (c) neutral images were animals or objects. Individuals with ASD performed selectively worse on emotion extraction, with no group differences for gender or animal?object tasks. The emotion extraction deficit remains even when controlling for gender, verbal ability, and age and is not accounted for by speed-accuracy tradeoffs. The deficit in rapid emotional processing may contribute to ASD difficulties in mimicry, empathy, and related processes. The results highlight the role of rapid early emotion processing in adaptive social?emotional functioning.2008 APA, all rights reserved

Recent research has indicated that autism is not a discrete disorder and that family members of autistic probands have an increased likelihood of exhibiting autistic symptoms with a wide range of severity, often below the threshold for a diagnosis of an autism spectrum disorder.To examine the distribution and genetic structure of autistic traits in the general population using a newly established quantitative measure of autistic traits, the Social Responsiveness Scale (formerly known as the Social Reciprocity Scale).The sample consisted of 788 pairs of twins aged 7 to 15 years, randomly selected from the pool of participants in a large epidemiologic study (the Missouri Twin Study). One parent of each pair of twins completed the Social Responsiveness Scale on each child. The data were subjected to structural equation modeling.Autistic traits as measured by the Social Responsiveness Scale were continuously distributed and moderately to highly heritable. Levels of severity of autistic traits at or above the previously published mean for patients with pervasive developmental disorder not otherwise specified were found in 1.4% of boys and 0.3% of girls. Structural equation modeling revealed no evidence for the existence of sex-specific genetic influences, and suggested specific mechanisms by which females may be relatively protected from vulnerability to autistic traits.These data indicate that the social deficits characteristic of autism spectrum disorders are common. Given the continuous distribution of these traits, it may be arbitrary where cutoffs are made between research designations of being "affected" vs "unaffected" with a pervasive developmental disorder. The genes influencing autistic traits appear to be the same for boys and girls. Lower prevalence (and severity) of autistic traits in girls may be the result of increased sensitivity to early environmental influences that operate to promote social competency.

Here we examine whether brain responses to dynamic facial expressions of pain are influenced by our responsibility for the observed pain. Participants played a flanker task with a confederate. Whenever either erred, the confederate was seen to receive a noxious shock. Using functional magnetic resonance imaging, we found that regions of the functionally localized pain-matrix of the participants (the anterior insula in particular) were activated most strongly when seeing the confederate receive a noxious shock when only the participant had erred (and hence had full responsibility). When both or only the confederate had erred (i.e. participant's shared or no responsibility), significantly weaker vicarious pain-matrix activations were measured. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Theories of empathy differ regarding the relative contributions of automatic resonance and perspective taking in understanding others' emotions. Patients with the rare syndrome of congenital insensitivity to pain cannot rely on "mirror matching" (i.e., resonance) mechanisms to understand the pain of others. Nevertheless, they showed normal fMRI responses to observed pain in anterior mid-cingulate cortex and anterior insula, two key regions of the so-called "shared circuits" for self and other pain. In these patients (but not in healthy controls), empathy trait predicted ventromedial prefrontal responses to somatosensory representations of others' pain and posterior cingulate responses to emotional representations of others' pain. These findings underline the major role of midline structures in emotional perspective taking and understanding someone else's feeling despite the lack of any previous personal experience of it--an empathic challenge frequently raised during human social interactions.

Empathy is thought to play a key role in motivating prosocial behavior, guiding our preferences and behavioral responses, and providing the affective and motivational base for moral development. While these abilities have traditionally been examined using behavioral methods, recent work in evolutionary biology, developmental and cognitive neuroscience has begun to shed light on the neural circuitry that instantiate them. The purpose of this article is to critically examine the current knowledge in the field of affective neuroscience and provide an integrative and comprehensive view of the computational mechanisms that underlie empathy. This framework is of general interest and relevance for theory as well as for assisting future research in the domains of affective developmental neuroscience and psychopathology.

In recent years, abundant evidence from behavioral and cognitive studies and functional-imaging experiments has indicated that individuals come to understand the emotional and affective states expressed by others with the help of the neural architecture that produces such states in themselves. Such a mechanism gives rise to shared representations, which constitutes one important aspect of empathy, although not the sole one. We suggest that other components, including people's ability to monitor and regulate cognitive and emotional processes to prevent confusion between self and other, are equally necessary parts of a functional model of empathy. We discuss data from recent functional-imaging studies in support of such a model and highlight the role of specific brain regions, notably the insula, the anterior cingulate cortex, and the right temporo-parietal region. Because this model assumes that empathy relies on dissociable information-processing mechanisms, it predicts a variety of structural or functional dysfunctions, depending on which mechanism is disrupted.

Empathy is the ability to experience and understand what others feel without confusion between oneself and others. Knowing what someone else is feeling plays a fundamental role in interpersonal interactions. In this paper, we articulate evidence from social psychology and cognitive neuroscience, and argue that empathy involves both emotion sharing (bottom-up information processing) and executive control to regulate and modulate this experience (top-down information processing), underpinned by specific and interacting neural systems. Furthermore, awareness of a distinction between the experiences of the self and others constitutes a crucial aspect of empathy. We discuss data from recent behavioral and functional neuroimaging studies with an emphasis on the perception of pain in others, and highlight the role of different neural mechanisms that underpin the experience of empathy, including emotion sharing, perspective taking, and emotion regulation.

Empathy is a concept central to psychiatry, psychotherapy and clinical psychology. The construct of empathy involves not only the affective experience of the other person's actual or inferred emotional state but also some minimal recognition and understanding of another's emotional state. It is proposed, in the light of multiple levels of analysis including social psychology, cognitive neuroscience and clinical neuropsychology, a model of empathy that involves both bottom-up and top-down information processing underpinned by parallel and distributed computational mechanisms. The predictive validity of this model is explored with reference to clinical conditions. As many psychiatric conditions are associated with deficits or even lack of empathy, we discuss a limited number of these disorders including psychopathy/antisocial personality disorders, borderline and narcissistic personality disorders, autistic spectrum disorders, and alexithymia. We argue that future clinical investigations of empathy disorders can only be informative if behavioral, dispositional and biological factors are combined.

The ontogeny of human empathy is better understood with reference to the evolutionary history of the social brain. Empathy has deep evolutionary, biochemical, and neurological underpinnings. Even the most advanced forms of empathy in humans are built on more basic forms and remain connected to core mechanisms associated with affective communication, social attachment, and parental care. In this paper, we argue that it is essential to consider empathy within a neurodevelopmental framework that recognizes both the continuities and changes in socioemotional understanding from infancy to adulthood. We bring together neuroevolutionary and developmental perspectives on the information processing and neural mechanisms underlying empathy and caring, and show that they are grounded in multiple interacting systems and processes. Moreover, empathy in humans is assisted by other abstract and domain-general high-level cognitive abilities such as executive functions, mentalizing and language, as well as the ability to differentiate another's mental states from one's own, which expand the range of behaviors that can be driven by empathy.Copyright © 2011 Elsevier Ltd. All rights reserved.

We have developed a toolbox and graphic user interface, EEGLAB, running under the crossplatform MATLAB environment (The Mathworks, Inc.) for processing collections of single-trial and/or averaged EEG data of any number of channels. Available functions include EEG data, channel and event information importing, data visualization (scrolling, scalp map and dipole model plotting, plus multi-trial ERP-image plots), preprocessing (including artifact rejection, filtering, epoch selection, and averaging), independent component analysis (ICA) and time/frequency decompositions including channel and component cross-coherence supported by bootstrap statistical methods based on data resampling. EEGLAB functions are organized into three layers. Top-layer functions allow users to interact with the data through the graphic interface without needing to use MATLAB syntax. Menu options allow users to tune the behavior of EEGLAB to available memory. Middle-layer functions allow users to customize data processing using command history and interactive 'pop' functions. Experienced MATLAB users can use EEGLAB data structures and stand-alone signal processing functions to write custom and/or batch analysis scripts. Extensive function help and tutorial information are included. A 'plug-in' facility allows easy incorporation of new EEG modules into the main menu. EEGLAB is freely available (http://www.sccn.ucsd.edu/eeglab/) under the GNU public license for noncommercial use and open source development, together with sample data, user tutorial and extensive documentation.

Selective attention is atypical in individuals with autism spectrum conditions. Evidence suggests this is also the case for those with high levels of autistic traits. Here we investigated the neural basis of spatial attention in those with high and low levels of self-reported autistic traits via analysis of ERP deflections associated with covert attention, target selection and distractor suppression (the N2pc, NT and PD). Larger N2pc and smaller PD amplitude was observed in those with high levels of autistic traits. These data provide neural evidence for differences in spatial attention, specifically, reduced distractor suppression in those with high levels of autistic traits, and may provide insight into the experience of perceptual overload often reported by individuals on the autism spectrum.

Empathy is a multidimensional construct consisting of cognitive (inferring mental states) and emotional (empathic concern) components. Despite a paucity of research, individuals on the autism spectrum are generally believed to lack empathy. In the current study we used a new, photo-based measure, the Multifaceted Empathy Test (MET), to assess empathy multidimensionally in a group of 17 individuals with Asperger syndrome (AS) and 18 well-matched controls. Results suggested that while individuals with AS are impaired in cognitive empathy, they do not differ from controls in emotional empathy. Level of general emotional arousability and socially desirable answer tendencies did not differ between groups. Internal consistency of the MET's scales ranged from.71 to.92, and convergent and divergent validity were highly satisfactory.

Attention management is often included in cognitive-behavioural treatments (CBT). The aim of this study was to evaluate the effects of attention management strategies in the treatment for chronic pain. The present pilot study consisted of six weekly 90-min treatment sessions and was based on a CBT attention management manual describing techniques such as attention diversion, imagery and mindfulness exercises. The intended outcomes were reduction in pain-related anxiety and hypervigilance to pain and decrease in pain impact of everyday life, measured by self-report. Information was collected at baseline, pre-treatment, post-treatment, and at 3 and 6 months follow-up. The results at the end of treatment, and at 3-month follow-up, show significant reductions in pain-related anxiety, hypervigilance and interference of pain (effect sizes 0.40-0.90). Reduction in pain-related interference and anxiety remained at the 6-month follow-up. The results indicate that attention control skills can be a useful method to reduce anxiety in the short term. Clinical implications of the results are discussed.

Previous neuroimaging studies have identified a neural circuit that is involved in empathy for pain. However, the temporal dynamics of neural activities underlying empathic processes remains poorly understood. This was investigated in the current study by recording event-related brain potentials (ERPs) from healthy adults who were presented with pictures or cartoons of hands that were in painful or neutral situations. Subjects performed a pain judgment task that required attention to pain cues in the stimuli or a counting task that withdrew their attention from these cues. The ERP results showed early differentiation between painful and neutral stimuli over the frontal lobe at 140 ms after sensory stimulation. A long-latency empathic response was observed after 380 ms over the central-parietal regions and was more salient over the left than right hemispheres. The early and late empathic responses were, respectively, modulated by contextual reality of stimuli and by top-down attention to the pain cues. Moreover, the mean ERP amplitudes at 140-180 ms were correlated with subjective reports of the degree of perceived pain of others and of self-unpleasantness. The ERP results support a model of empathy for pain consisting of early emotional sharing and late cognitive evaluation.

G*Power (Erdfelder, Faul, & Buchner, 1996) was designed as a general stand-alone power analysis program for statistical tests commonly used in social and behavioral research. G*Power 3 is a major extension of, and improvement over, the previous versions. It runs on widely used computer platforms (i.e., Windows XP, Windows Vista, and Mac OS X 10.4) and covers many different statistical tests of the t, F, and chi2 test families. In addition, it includes power analyses for z tests and some exact tests. G*Power 3 provides improved effect size calculators and graphic options, supports both distribution-based and design-based input modes, and offers all types of power analyses in which users might be interested. Like its predecessors, G*Power 3 is free.

Altered sensory perception has been found in patients with autism spectrum disorders (ASD) and might be related to aberrant sensory perception thresholds. We used the well-established, standardized Quantitative sensory testing (QST) protocol of the German Research Network on Neuropathic Pain to investigate 13 somatosensory parameters including thermal and tactile detection and pain thresholds in 13 ASD adults and 13 matched healthy controls with normal IQ values. There were no group differences between somatosensory detection and pain thresholds. Two ASD patients showed paradoxical heat sensations and another two ASD subjects presented dynamic mechanical allodynia; somatosensory features that were absent in controls. These findings suggest that central mechanisms during complex stimulus integration rather than peripheral dysfunctions probably determine somatosensory alterations in ASD.

Previous neurophysiological research suggests that there are event-related potential (ERP) components associated with empathy for pain: an early affective component (N2) and two late cognitive components (P3/LPP). The current study investigated whether and how the visual perspective from which a painful event is observed affects these ERP components. Participants viewed images of hands in pain vs. not in pain from a first-person or third-person perspective. We found that visual perspective influences the early and late components. In the early component (N2), there was a larger mean amplitude during observation of pain vs no-pain when images were shown from a first-person perspective. We suggest that this effect may be driven by misattributing the on-screen hand to oneself. For the late component (P3), we found a larger effect of pain on mean amplitudes in response to third-person relative to first-person images. We speculate that the P3 may reflect a later process that enables effective recognition of others' pain in the absence of misattribution. We discuss our results in relation to self- vs other-related processing by questioning whether these ERP components are truly indexing empathy (an other-directed process) or a simple misattribution of another's pain as one's own (a self-directed process).

Theory and research suggests that features of autism are not restricted to individuals diagnosed with autism spectrum disorders (ASDs), and that autism-like traits vary throughout the general population at lower severities. The present research first investigated the relationship of autism traits with trait emotional intelligence and empathy in a sample of 163 adults aged between 18 and 51 years (44% male). It then examined performance on a set of tasks assessing social cognition and cognitive flexibility in 69 participants with either high or low scores on ASD traits. Results confirm that there is pronounced variation within the general population relating to ASD traits, which reflect similar (though less severe) social-cognitive and emotional features to those observed in ASDs. © 2013 The British Psychological Society.

Accumulating evidence suggests that autonomic signals and their cortical representations are closely linked to emotional processes, and that related abnormalities could lead to social deficits. Although socio-emotional impairments are a defining feature of autism spectrum disorder (ASD), empirical evidence directly supporting the link between autonomic, cortical, and socio-emotional abnormalities in ASD is still lacking. In this study, we examined autonomic arousal indexed by skin conductance responses (SCR), concurrent cortical responses measured by functional magnetic resonance imaging, and effective brain connectivity estimated by dynamic causal modeling in seventeen unmedicated high-functioning adults with ASD and seventeen matched controls while they performed an empathy-for-pain task. Compared to controls, adults with ASD showed enhanced SCR related to empathetic pain, along with increased neural activity in the anterior insular cortex, although their behavioral empathetic pain discriminability was reduced and overall SCR was decreased. ASD individuals also showed enhanced correlation between SCR and neural activities in the anterior insular cortex. Importantly, significant group differences in effective brain connectivity were limited to greater reduction in the negative intrinsic connectivity of the anterior insular cortex in the ASD group, indicating a failure in attenuating anterior insular responses to empathetic pain. These results suggest that aberrant interoceptive precision, as indexed by abnormalities in autonomic activity and its central representations, may underlie empathy deficits in ASD.© 2015 Wiley Periodicals, Inc.

Autism spectrum disorder (ASD) is marked by both socio-communicative difficulties and abnormalities in sensory processing. Much of the work on sensory deficits in ASD has focused on tactile sensations and the perceptual aspects of somatosensation, such as encoding of stimulus intensity and location. Although aberrant pain processing has often been noted in clinical observations of patients with ASD, it remains largely uninvestigated. Importantly, the neural mechanism underlying higher order cognitive aspects of pain processing such as pain anticipation also remains unknown. Here we examined both pain perception and anticipation in high-functioning adults with ASD and matched healthy controls (HC) using an anticipatory pain paradigm in combination with functional magnetic resonance imaging (fMRI) and concurrent skin conductance response (SCR) recording. Participants were asked to choose a level of electrical stimulation that would feel moderately painful to them. Compared to HC group, ASD group chose a lower level of stimulation prior to fMRI. However, ASD participants showed greater activation in both rostral and dorsal anterior cingulate cortex during the anticipation of stimulation, but not during stimulation delivery. There was no significant group difference in insular activation during either pain anticipation or perception. However, activity in the left anterior insula correlated with SCR during pain anticipation. Taken together, these results suggest that ASD is marked with aberrantly higher level of sensitivity to upcoming aversive stimuli, which may reflect abnormal attentional orientation to nociceptive signals and a failure in interoceptive inference.© 2017 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

阈下自闭特质是正常人群表现出来的, 自闭症谱系障碍(Autism Spectrum Disorder, ASD)阈限以下温和的社会性、交流能力损伤以及与ASD相关的人格和认知特征。其研究有助于ASD的干预及对ASD实质的更好理解。研究者用共情–系统化理论对其进行了理论解释。近来研究表明阈下自闭特质的结构与ASD核心行为维度类似, 且遗传、性别、认知风格等因素影响阈下自闭特质水平。未来研究应更有效地对阈下自闭特质进行评估, 并进一步探讨其可能存在的病理性质、与ASD的理论界限等问题。

<p id="p00005"> Autism spectrum disorders (ASD) is a pervasive neurodevelopmental disorder. ASD individuals usually show persistent social communication barriers, social interaction barriers, and repetitive stereotyped behavior patterns in many situations. Furthermore, the empathy deficits in ASD individuals may be the main reason for their social interaction barriers. The mind-blindness hypothesis and the empathizing-systemizing theory explain their empathy deficits from two perspectives respectively, as well as put forward two different empathy intervention programs.<br>The mind-blindness hypothesis claimed that the empathy deficits in ASD individuals were mainly caused by the lack of theory of mind, indicating that they couldn’t understand others’ emotions and thoughts, which derived the empathy method of “making up for weaknesses” according to this characteristic. This category of intervention program advocated that the empathy deficits in ASD individuals should be directly intervened through corresponding empathic intervention programs to improve their empathic ability. The empathy method of “making up for weaknesses” mainly included the theory of mind (TOM) intervention, the perspective-taking intervention, the intervention of facial expression cognition, and so on. The empathy method of "making up for weaknesses" could improve the empathy ability of ASD individuals to some extent, but this category of intervention program required higher ability of ASD individuals. Additionally, it only could improve their skills related to the intervention contents instead of improving other aspects of their obstacles.<br>The empathizing-systemizing theory emphasized that although the lack of empathy ability of ASD individuals resulted in their social interaction deficits, their systematic capability was excellent, and even surpassed the general individuals, which derived the empathy method of “giving full play to strengths”. Based on the systematic strengths and interests of ASD individuals, the empathy method of "giving full play to strengths" proposed to increase their sense of self-efficacy and empathy by strengthening and encouraging them to do what they were good at, and thus improved their empathy ability. The method of “giving full play to strengths” mainly included the LEGO therapy, the serious games intervention, and the island-based intervention based on systemizing theory, and so on. The empathy method of “giving full play to strengths” emphasized that the advantages of systematic ability of ASD individuals should be used to make up for the weaknesses of their empathy deficits, so that ASD individuals could systematically accept empathy tasks and thus improve their empathy ability. However, the generalization and migration of such intervention programs have been questioned. In summary, the empathy method of "giving full play to strengths" provided a new idea for the intervention of empathy ability of ASD individuals.<br>The above two kinds of intervention programs had their own advantages and disadvantages. It is suggested that future interventions should not only take into full consideration to the diversity of each ASD individual, such as age, sex, severity of symptom and so on, but also pay more attention to the superior abilities of ASD individuals, carry out the multi-channel and multi-modality comprehensive interventions, as well as combine the island-based intervention based on systemizing theory with the “making up for weaknesses” and “giving full play to strengths” programs to formulate an individualized intervention plan for each ASD individual.</p>

自闭症谱系障碍(autism spectrum disorders, ASD)个体的共情能力缺陷可能导致了他们的社会交往障碍, 因此有必要对ASD个体的共情能力进行干预。有研究者主张应该对ASD个体的共情缺陷进行直接干预, 由此衍生了共情“补短”法, 主要包括心理理论的干预、观点采择的干预、面部表情认知的干预等几种方法。另有一些研究者认为虽然ASD个体存在共情缺陷, 但他们同时也具备系统化能力优势, 应该通过ASD个体的优势能力来改善其共情能力, 由此衍生了共情“扬长”法, 主要包括乐高治疗、严肃游戏干预、基于系统化理论的孤岛能力辅助干预等几种方法。每种方法都存在优点和不足。最后就目前ASD个体共情干预领域存在的问题进行了反思与展望。

To what extent do we share feelings with others? Neuroimaging investigations of the neural mechanisms involved in the perception of pain in others may cast light on one basic component of human empathy, the interpersonal sharing of affect. In this fMRI study, participants were shown a series of still photographs of hands and feet in situations that are likely to cause pain, and a matched set of control photographs without any painful events. They were asked to assess on-line the level of pain experienced by the person in the photographs. The results demonstrated that perceiving and assessing painful situations in others was associated with significant bilateral changes in activity in several regions notably, the anterior cingulate, the anterior insula, the cerebellum, and to a lesser extent the thalamus. These regions are known to play a significant role in pain processing. Finally, the activity in the anterior cingulate was strongly correlated with the participants' ratings of the others' pain, suggesting that the activity of this brain region is modulated according to subjects' reactivity to the pain of others. Our findings suggest that there is a partial cerebral commonality between perceiving pain in another individual and experiencing it oneself. This study adds to our understanding of the neurological mechanisms implicated in intersubjectivity and human empathy.

We explored the relationships between 'autistic' traits as measured by the AQ (Autism-Spectrum Quotient; Baron-Cohen et al., J. Autism Develop. Disord. (2001b) 31 5) and various personality traits or cognitive ability, which usually coincide with autistic symptoms, for general populations. Results showed the AQ was associated with tendencies toward an obsessional personality as defined by the TCI (Temperament and Character Inventory), higher depression and anxiety, and higher frequency of experience of being bullied. These results parallel the patterns in autism and corroborate the validity of the AQ for general populations. Contrary to our prediction, however, there was no relationship between the AQ and cognitive ability, such as theory of mind, executive functioning, and central coherence, suggesting the AQ does not reflect autism-specific cognitive patterns in general populations.

A growing body of evidence suggests that empathy for pain is underpinned by neural structures that are also involved in the direct experience of pain. In order to assess the consistency of this finding, an image-based meta-analysis of nine independent functional magnetic resonance imaging (fMRI) investigations and a coordinate-based meta-analysis of 32 studies that had investigated empathy for pain using fMRI were conducted. The results indicate that a core network consisting of bilateral anterior insular cortex and medial/anterior cingulate cortex is associated with empathy for pain. Activation in these areas overlaps with activation during directly experienced pain, and we link their involvement to representing global feeling states and the guidance of adaptive behavior for both self- and other-related experiences. Moreover, the image-based analysis demonstrates that depending on the type of experimental paradigm this core network was co-activated with distinct brain regions: While viewing pictures of body parts in painful situations recruited areas underpinning action understanding (inferior parietal/ventral premotor cortices) to a stronger extent, eliciting empathy by means of abstract visual information about the other's affective state more strongly engaged areas associated with inferring and representing mental states of self and other (precuneus, ventral medial prefrontal cortex, superior temporal cortex, and temporo-parietal junction). In addition, only the picture-based paradigms activated somatosensory areas, indicating that previous discrepancies concerning somatosensory activity during empathy for pain might have resulted from differences in experimental paradigms. We conclude that social neuroscience paradigms provide reliable and accurate insights into complex social phenomena such as empathy and that meta-analyses of previous studies are a valuable tool in this endeavor.Copyright © 2010 Elsevier Inc. All rights reserved.

The link between parental autistic tendency and anxiety symptoms was studied in 491 Taiwanese couples raising biological children with autism spectrum disorders (ASDs). Parental autistic tendency as measured by Autism Spectrum Quotient (AQ) was associated with anxiety symptoms across all domains. Large effect sizes were found in social phobia and post traumatic stress disorders for both parents, and in general anxiety disorder and agoraphobia for mothers. These associations were irrespective of child's autistic tendency, spouse's AQ scores and the couples' compatibility in their autistic tendency. Perceived family support and parental education moderated the link but not child's autistic severity. Research and clinical implications regarding psychiatric vulnerability of parents of children with ASD were drawn and discussed.

Recent event-related brain potential (ERP) study disentangled an early automatic component and a late top-down controlled component of neural activities to perceived pain of others. This study assessed the hypothesis that perspective taking modulates the top-down controlled component but not the automatic component of empathy for pain by recording ERPs from 24 subjects who performed pain judgments of pictures of hands in painful or non-painful situations from either self-perspective or other-perspective. We found that, relative to non-painful stimuli, painful stimuli induced positive shifts of ERPs at frontal-central electrodes as early as 160 ms after sensory stimulation and this effect lasted until 700 ms. The amplitudes of ERPs at 230-250 ms elicited by painful stimuli negatively correlated with both subjective ratings of others' pain and self-unpleasantness in both self-perspective and other-perspective conditions. Neural response to perceived pain over the central-parietal area was significantly reduced at 370-420 ms when performing the pain judgment task from other-perspective compared to self-perspective. The results suggest that shifting between self-perspectives and other-perspectives modulates the late controlled component but not the early automatic component of neural responses to perceived pain.(c) 2009 Elsevier Ireland Ltd. All rights reserved.

Previous studies have found that the behavioral patterns of individuals with autistic traits are similar to those of individuals with autism spectrum disorders (ASD). That is, individuals with autistic traits show the impairment of empathy in daily life, but the severity of such impairment is not enough to meet the clinical diagnostic criteria for ASD. The similar behaviors between the two mean that studying individuals with autistic traits can help us understand the empathy characteristics of ASD. At present, the results of studies on the empathy for pain of autistic individuals are not consistent. It is possible that attention cues and specific face processing affect their empathy processing. Therefore, in this study, pictures of painful faces were used as stimulus materials, and the event-related potentials (ERP) technique was adopted to explore the effect of attention cues on the pain empathy processing in autistic individuals. The study randomly selected 30 healthy undergraduates (15 males) as the autistic trait group, and 30 healthy undergraduates (16 males) as the control group. The experiment, based on three-factor mixed design (2×2×2), included two tasks: 1) Pain judgment task: The subjects were required to judge whether there was pain in the pictures of the painful faces (with a needle in the cheek) and the pictures of the non-painful faces (touched gently with a cotton swab), where the subjects' attention was directed to the pain cues. 2) Attractiveness judgment task: The subjects were required to judge whether the faces were attractive or unattractive, where the subjects' attention did not point to the pain cues. EEG during the observation of pictures under different experiment tasks was recorded by a 64-channel amplifier using a standard 10-20 system (Brain Products). The ERP results revealed that the attention cues would influence the late cognitive processing stage component P3, but not the early automatic component. Compared with the control group, the autistic trait group induced a larger P3 amplitude by the painful face pictures in the attractiveness judgment task; however, in the pain judgment task, there was no significant difference between the two groups. This suggests that top-down attention to visual pain cues may modulate the late processing of pain empathy in autistic individuals, as manifested in the following fact: When autistic individuals pay attention to pain cues, they have similar empathic neural responses to the control group; when they do not pay attention to pain cues, they process other people's painful faces to a higher degree. This result also suggests that autistic individuals may avoid other people's face information, and provides evidence for the empathy deficit of autistic individuals. This conclusion is helpful for understanding the cognitive processing characteristics and influencing factors of pain empathy in ASD.

Despite extensive research, it is still debated whether impairments in social skills of individuals with pervasive developmental disorder (PDD) are related to specific deficits in the early processing of emotional information. We aimed to test both automatic processing of facial affect as well as the integration of auditory and visual emotion cues in individuals with PDD.In a group of high-functioning adult individuals with PDD and an age- and IQ-matched control group, we measured facial electromyography (EMG) following presentation of visual emotion stimuli (facial expressions) as well as the presentation of audiovisual emotion pairs (faces plus voices). This emotionally driven EMG activity is considered to be a direct correlate of automatic affect processing that is not under intentional control.Our data clearly indicate that among individuals with PDD facial EMG activity is heightened in response to happy and fearful faces, and intact in response to audiovisual affective information.This study provides evidence for enhanced sensitivity to facial cues at the level of reflex-like emotional responses in individuals with PDD. Furthermore, the findings argue against impairments in crossmodal affect processing at this level of perception. However, given how little comparative work has been done in the area of multisensory perception, there is certainly need for further exploration.

Fear and/or anxiety about pain is a useful construct, in both theoretical and clinical terms. This article describes the development and refinement of the Fear of Pain Questionnaire (FPQ), which exists in its most current form as the FPQ-III. Factor analytic refinement resulted in a 30-item FPQ-III which consists of Severe Pain, Minor Pain, and Medical Pain subscales. Internal consistency and test-retest reliability of the FPQ-III were found to be good. Four studies are presented, including normative data for samples of inpatient chronic pain patients, general medical outpatients, and unselected undergraduates. High fear of pain individuals had greater avoidance/escape from a pain-relevant Behavioral Avoidance Test with Video, relative to their low fear counterparts, suggesting predictive validity. Chronic pain patients reported the greatest fear of severe pain. Directions for future research with the FPQ-III are discussed, along with general comments about the relation of fear and anxiety to pain.

Asperger syndrome (AS) is a neurodevelopmental condition within the autism spectrum conditions (ASC) characterized by specific difficulties in communication, social interaction, and empathy that is essential for sharing and understanding others' feelings and emotions. Although reduced empathy is considered a core feature of ASC, neurophysiological evidence of empathic deficits before and below mentalizing and perspective taking is lacking. We explored whether people with AS differ from neurotypical control participants in their empathic corticospinal response to the observation of others' pain and the modulatory role played by phenomenal experience of observed pain and personality traits.Sixteen right-handed men with AS (aged 28.0+/-7.2 years) and 20 neurotypical controls (aged 25.3+/-6.7 years) age, sex, and IQ matched, underwent single-pulse transcranial magnetic stimulation during observation of painful and nonpainful stimuli affecting another individual.When observing other's pain, participants with AS, in contrast to neurotypical control participants, did not show any amplitude reduction of motor-evoked potentials recorded from the muscle vicariously affected by pain, nor did their neurophysiological response correlate with imagined pain sensory qualities. Participants with AS represented others' pain in relation to the self-oriented arousal experienced while watching pain videos.Finding no embodiment of others' pain provides neurophysiological evidence for reduced empathic resonance in people with AS and indicates that their empathic difficulties involve not only cognitive dimensions but also sensorimotor resonance with others. We suggest that absence of embodied empathy may be linked to changes at very basic levels of neural processing.

Simulation theories of empathy hypothesize that empathizing with others' pain shares some common psychological computations with the processing of one's own pain. Support for this perspective has largely relied on functional neuroimaging evidence of an overlap between activations during the experience of physical pain and empathy for other people's pain. Here, we extend the functional overlap perspective to the neurochemical level and test whether a common physical painkiller, acetaminophen (paracetamol), can reduce empathy for another's pain. In two double-blind placebo-controlled experiments, participants rated perceived pain, personal distress and empathic concern in response to reading scenarios about another's physical or social pain, witnessing ostracism in the lab, or visualizing another study participant receiving painful noise blasts. As hypothesized, acetaminophen reduced empathy in response to others' pain. Acetaminophen also reduced the unpleasantness of noise blasts delivered to the participant, which mediated acetaminophen's effects on empathy. Together, these findings suggest that the physical painkiller acetaminophen reduces empathy for pain and provide a new perspective on the neurochemical bases of empathy. Because empathy regulates prosocial and antisocial behavior, these drug-induced reductions in empathy raise concerns about the broader social side effects of acetaminophen, which is taken by almost a quarter of adults in the United States each week.© The Author (2016). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Pain is a complex experience with sensory, emotional and cognitive aspects. The cortical representation of pain - the pain matrix - consists of a network of regions including the primary (S1) and secondary (S2) sensory cortex, insula, and anterior cingulate cortex (ACC). These structures interact with brain regions such as the prefrontal cortex and the amygdalae. Simultaneous EEG/fMRI (electroencephalography/functional magnetic resonance imaging) has recently been introduced as a method to study the spatiotemporal characteristics of cognitive processes with high spatial and high temporal resolution at the same time. The present study was conducted to clarify if single trial EEG-informed BOLD modeling supports the definition of functional compartments within the pain matrix and interconnected regions. Twenty healthy subjects received painful laser stimulation while EEG and the fMRI blood oxygen level dependent (BOLD) signal were recorded simultaneously. While the laser-evoked N2 potential provided no additional information for BOLD modeling, the regressor obtained from the single trial laser-evoked P2 potential explained additional variance in a network of cortical and subcortical structures that largely overlapped with the pain matrix. This modeling strategy yielded pronounced activation in the ACC, right amygdala and thalamus. Our results suggest that laser-evoked potential (LEP) informed fMRI can be used to visualize BOLD activation in the pain matrix with an emphasis on functional compartments (as defined by the temporal dynamics of the LEP) such as the medial pain system. Furthermore, our findings suggest a concerted effort of the ACC and the amygdala in the cognitive-emotional evaluation of pain.

In addition to the diagnostic criteria for autism spectrum disorder, a number of clinically important comorbid complaints, including sensory abnormalities, are also discussed. One difference often noted in these accounts is hyposensitivity to pain; however, evidence for this is limited. The purpose of the current review therefore was to examine sensitivity to pain of individuals with autism spectrum disorder. This review is interested in reports which consider differences in subjective experience of pain (i.e. different pain thresholds) and differences in behavioural response to pain (i.e. signs of pain-related distress). Studies were included if they were conducted with human subjects, included a clearly diagnosed autism spectrum disorder population and reported data pertaining to pain experience relative to the neurotypical population. Studies were classified as being self/parent report, clinical observations, observations of response to medical procedures or experimental examination of pain. Both self/parent report and clinical observations appeared to report hyposensitivity to pain, whereas observations of medical procedures and experimental manipulation suggested normal or hypersensitive responses to pain. This review suggests that contrary to classical reports, individuals with autism spectrum disorder do not appear to have systematically altered pain responses or thresholds. More systematic experimental examination of this area is needed to understand responses to pain of individuals with autism spectrum disorder. © The Author(s) 2014.

Real-life social processing abilities of adults with autism spectrum disorders (ASD) can be hard to capture in lab-based experimental tasks. A novel measure of social cognition, the "Strange Stories Film task' (SSFt), was designed to overcome limitations of available measures in the field. Brief films were made based on the scenarios from the Strange Stories task (Happé) and designed to capture the subtle social-cognitive difficulties observed in ASD adults. Twenty neurotypical adults were recruited to pilot the new measure. A final test set was produced and administered to a group of 20 adults with ASD and 20 matched controls, alongside established social cognition tasks and questionnaire measures of empathy, alexithymia and ASD traits. The SSFt was more effective than existing measures at differentiating the ASD group from the control group. In the ASD group, the SSFt was associated with the Strange Stories task. The SSFt is a potentially useful tool to identify social cognitive dis/abilities in ASD, with preliminary evidence of adequate convergent validity. Future research directions are discussed. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 1120-1132. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.© 2017 International Society for Autism Research, Wiley Periodicals, Inc.

Guided by a recent theory that proposes fundamental differences in how autistic individuals deal with uncertainty, we investigated the extent to which the cognitive construct 'intolerance of uncertainty' and anxiety were related to parental reports of sensory sensitivities in 64 autistic and 85 typically developing children aged 6-14 years. Intolerance of uncertainty and anxiety explained approximately half the variance in autistic children's sensory sensitivities, but only around a fifth of the variance in typical children's sensory sensitivities. In children with autism only, intolerance of uncertainty remained a significant predictor of children's sensory sensitivities once the effects of anxiety were adjusted for. Our results suggest intolerance of uncertainty is a relevant construct to sensory sensitivities in children with and without autism.

Spontaneous mimicry, including that of emotional facial expressions, is important for socio-emotional skills such as empathy and communication. Those skills are often impacted in autism spectrum disorders (ASD). Successful mimicry requires not only the activation of the response, but also its appropriate speed. Yet, previous studies examined ASD differences in only response magnitude. The current study investigated timing and magnitude of spontaneous and voluntary mimicry in ASD children and matched controls using facial electromyography (EMG). First, participants viewed and recognized happy, sad, fear, anger, disgust and neutral expressions presented at different durations. Later, participants voluntarily mimicked the expressions. There were no group differences on emotion recognition and amplitude of expression-appropriate EMG activity. However, ASD participants' spontaneous, but not voluntary, mimicry activity was delayed by about 160 ms. This delay occurred across different expressions and presentation durations. We relate these findings to the literature on mirroring and temporal dynamics of social interaction.

Although individuals with autism spectrum disorder (ASD) have impaired responses to interpersonal touch, the underlying neural correlates remain largely unknown. Here, we examined the neural correlates that underlie interpersonal touch perception in individuals with either high or low autistic traits. Fifty-three participants were classified as having either high or low autistic traits based on their performance on the autism quotient (AQ) questionnaire. We hypothesized that individuals with high AQ scores would have relatively high touch hypervigilance, reflected as earlier P1 and stronger late positive potential (LPP) responses, two components of event-related potentials that serve as electrophysiological markers of anxiety bias. We recorded each participant's electroencephalography activity during presentation of images depicting human touch, object touch, and non-touch control images. Consistent with our hypothesis, AQ scores were positively correlated with social touch aversion. Moreover, participants with high AQ scores had earlier P1 and stronger LPP responses when presented with human touch compared to the control images. Importantly, a regression model revealed that earlier P1 and larger LPP amplitude measured during social touch observation can accurately predict higher autistic trait levels. Taken together, these findings indicate that individuals with high levels of autistic traits may have a hypervigilant response to observed social touch. Autism Res 2017, 0: 000-000. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 1141-1154. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.© 2017 International Society for Autism Research, Wiley Periodicals, Inc.

Autism spectrum conditions (ASC) has recently been associated with increased risk of suicidality. However, no studies have explored how autistic traits may interact with current models of suicidal behavior in a non-clinical population. The current study therefore explored how self-reported autistic traits interact with perceived burdensomeness and thwarted belongingness in predicting suicidal behavior, in the context of the Interpersonal-Psychological Theory of Suicide (IPTS). 163 young adults (aged 18-30 years) completed an online survey including measures of thwarted belonging and perceived burdensomeness (Interpersonal Needs Questionnaire), self-reported autistic traits (Autism Spectrum Quotient), current depression (Centre for Epidemiological Studies Depression Scale), and lifetime suicidality (Suicide Behavior Questionnaire-Revised). Results showed that burdensomeness and thwarted belonging significantly mediated the relationship between autistic traits and suicidal behavior. Both depression and autistic traits significantly predicted thwarted belonging and perceived burdensomeness. Autistic traits did not significantly moderate the relationship between suicidal behavior and thwarted belonging or perceived burdensomeness. Results suggest that the IPTS provides a useful framework for understanding the influence of autistic traits on suicidal behavior. However, the psychometric properties of these measures need be explored in those with clinically confirmed diagnosis of ASC. Autism Res 2017, 10: 1891-1904. © 2017 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc.Recent research has shown that people with high autistic traits are more likely to attempt suicide. However, no studies have explored why. We found that people with high autistic traits were more likely to experience feelings that they do not belong in the world, are a burden on others, and depression, which may increase their likelihood of attempting suicide. These results suggest that promoting inclusion and independence in those with high autistic traits could help prevent people attempting suicide.© 2017 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc.

Predictability has been suggested to modulate both the anticipation and perception of self-pain. Considering the overlapping neural circuits between self-pain and other-pain perceptions, the present study investigated how the predictability of forthcoming pain modulates the anticipation and perception of self-pain and other-pain. We used a balanced, within-participant experimental design in which a visual cue indicating the recipient, intensity and predictability of an upcoming painful electrical stimulation was presented before its delivery. Subjective ratings and electroencephalography activities to the anticipation and perception of self-pain and other-pain were recorded and compared between certain and uncertain conditions. Results showed that predictability affected the perception of self-pain and other-pain in a similar manner such that the differences in behavioral ratings and event-related potentials to high-intensity and low-intensity pain were significantly reduced when the intensity was uncertain. The strengths of predictability-induced modulation of self-pain and other-pain perceptions were positively correlated with each other. Furthermore, predictability also modulated the anticipation of both self-pain and other-pain such that pre-stimulus high-frequency α-oscillation power at sensorimotor electrodes contralateral to the stimulation side was maximally suppressed when anticipating certain high-intensity pain. These findings demonstrate that predictability-induced modulation on pain anticipation and perception was similarly applied to both self-pain and other-pain.© The Author(s) 2019. Published by Oxford University Press.

Factors influencing the rate, form, and severity of phenotypic expression among relatives of autistic probands are examined. Family history data on 3095 first- and second-degree relatives and cousins from 149 families with a child with autism and 36 families with a child with Down syndrome are studied. The results provide further evidence of an increased risk among autism relatives for the broadly defined autism phenotype. Of proband characteristics, severity of autism and obstetric optimality were confirmed as being related to familial loading for probands with speech. There was little variation in loading among probands lacking speech. The type of phenotypic profile reported in relatives appeared little influenced by characteristics of the relative or the proband, except for variation by degree of relative, parental status of relative, and perhaps proband's birth optimality score. Phenotypic rates among parents suggested reduced fitness for the severest and more communication-related forms of expression but not for the more mild and social forms of expression. Patterns of expression within the families did not support a simple X-linked nor an imprinted X-linked mode of inheritance. The basis for sex differences in rates of expression is discussed.

Studies of families ascertained through a single autistic proband suggest that the genetic liability for autism may be expressed in nonautistic relatives in a phenotype that is milder but qualitatively similar to the defining features of autism. The objective of this study was to examine behaviors that may define this broader phenotype in relatives ascertained through two autistic siblings.The authors used a semistructured family history interview to compare the rates of social and communication deficits and stereotyped behaviors in relatives ascertained through two autistic siblings (families with multiple-incidence autism; 25 families) with the rates in relatives of Down syndrome probands (30 families).Higher rates of social and communication deficits and stereotyped behaviors were found in the relatives in the families with multiple-incidence autism.These data suggest that further studies should be undertaken to delineate the boundaries of the broader autism phenotype and that this broader phenotype should be included in some future genetic analyses of this disorder.

This study investigated the mind-reading abilities of 19 adults with Asperger syndrome and 19 typically developing adults. Two static mind-reading tests and a more naturalistic empathic accuracy task were used. In the empathic accuracy task, participants attempted to infer the thoughts and feelings of target persons, while viewing a videotape of the target persons in a naturally occurring conversation with another person. The results are consistent with earlier findings. The empathic accuracy task indicated significant between-group differences, whereas no such differences were found on the static mind-reading tasks. The most innovative finding of the present study is that the inference ability of adults with pervasive developmental disorder (PDD) and controls depends on the focus of the target's thoughts and feelings, and that the empathic accuracy of adults with Asperger syndrome and control adults might be different in terms of quantity and quality.

Hypotheses involving mediation are common in the behavioral sciences. Mediation exists when a predictor affects a dependent variable indirectly through at least one intervening variable, or mediator. Methods to assess mediation involving multiple simultaneous mediators have received little attention in the methodological literature despite a clear need. We provide an overview of simple and multiple mediation and explore three approaches that can be used to investigate indirect processes, as well as methods for contrasting two or more mediators within a single model. We present an illustrative example, assessing and contrasting potential mediators of the relationship between the helpfulness of socialization agents and job satisfaction. We also provide SAS and SPSS macros, as well as Mplus and LISREL syntax, to facilitate the use of these methods in applications.

The Pain Sensitivity Questionnaire (PSQ), a self-reported scale, has been used to assess the pain sensitivity level in a Caucasian population. However, a validated Mandarin Chinese version of the PSQ is not available. This study was aimed to translate the PSQ into Mandarin Chinese (PSQ-C) and validate it to measure pain sensitivity among Chinese people.The English version of the PSQ has been translated into Mandarin Chinese (PSQ-C), according to the standard steps of cross-cultural adaptation of self-reported scales. Three of the 17 items were revised owing to cultural adaptation. The final version was validated on a population of 182 Chinese people in Changsha City, China, during October to December 2015. The participants underwent electrical experimental pain testing. The psychometric properties of the PSQ-C and its subscales were examined.The Cronbach's alpha coefficients for the PSQ-C-total, PSQ-C-moderate, and PSQ-C-minor were 0.90, 0.86, and 0.81, respectively. Acceptable test-retest reliability, content validity, and construct validity were demonstrated. Concurrent validity was shown via significant positive correlations between PSQ-C scores and perceived pain intensity at pain threshold and during pain stimulation with a fixed intensity. Convergent validity was shown via significant positive correlations between Pain Catastrophizing Scale scores and PSQ-C scores. Known group validity was demonstrated via higher PSQ-C-total and PSQ-C-moderate scores among those with high neuroticism scores. These results indicate that the PSQ-C has reasonably good psychometric properties, similar to the original English and German versions.The PSQ-C is a reliable and useful tool to assess pain sensitivity levels in a Chinese population.© 2017 World Institute of Pain.

There is a lack of knowledge about pain reactions in children with autism spectrum disorders (ASD), who have often been considered as insensitive to pain. The objective of this study was to describe the facial, behavioral and physiological reactions of children with ASD during venipuncture and to compare them to the reactions of children with an intellectual disability and nonimpaired control children. We also examined the relation between developmental age and pain reactions. The sample included 35 children with ASD, 32 children with an intellectual disability, and 36 nonimpaired children. The children were videotaped during venipuncture and their heart rate was recorded. Facial reactions were assessed using the Child Facial Coding System (CFCS) and behavioral reactions were scored using the Noncommunicating Children's Pain Checklist (NCCPC). A linear mixed-effects model showed that children's reactions increased between baseline and venipuncture and decreased between the end of venipuncture and the recovery period. There was no significant difference between groups regarding the amount of facial, behavioral and physiological reactions. However, behavioral reactions seemed to remain high in children with ASD after the end of the venipuncture, in contrast with children in the 2 other groups. Moreover, we observed a significant decrease in pain expression with age in nonimpaired children, but no such effect was found regarding children with ASD. The data reveal that children with ASD displayed a significant pain reaction in this situation and tend to recover more slowly after the painful experience. Improvement in pain assessment and management in this population is necessary. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Genetic factors play an important role in the etiology of both autism spectrum disorders and autistic traits. However, little is known about the etiologic consistency of autistic traits across levels of severity.To compare the etiology of typical variation in autistic traits with extreme scoring groups (including top 1%) that mimicked the prevalence of diagnosed autism spectrum disorders in the largest twin study of autistic traits to date.Twin study using phenotypic analysis and genetic model-fitting in the total sample and extreme scoring groups (top 5%, 2.5%, and 1%).A nationally representative twin sample from the general population of England.The families of 5968 pairs aged 12 years old in the Twins' Early Development Study. Main Outcome Measure  Autistic traits as assessed by the Childhood Autism Spectrum Test.Moderate to high heritability was found for autistic traits in the general population (53% for females and 72% for males). High heritability was found in extreme-scoring groups. There were no differences in heritability among extreme groups or between the extreme groups and the general population. A continuous liability shift toward autistic trait affectedness was seen in the cotwins of individuals scoring in the top 1%, suggesting shared etiology between extreme scores and normal variation.This evidence of similar etiology across normal variation and the extremes has implications for molecular genetic models of autism spectrum disorders and for conceptualizing autism spectrum disorders as the quantitative extreme of a neurodevelopmental continuum.

A deficit in empathy has consistently been cited as a central characteristic of Asperger syndrome (AS), but previous research on adults has predominantly focused on cognitive empathy, effectively ignoring the role of affective empathy. We administered the Interpersonal Reactivity Index (IRI), a multi-dimensional measure of empathy, and the Strange Stories test to 21 adults with AS and 21 matched controls. Our data show that while the AS group scored lower on the measures of cognitive empathy and theory of mind, they were no different from controls on one affective empathy scale of the IRI (empathic concern), and scored higher than controls on the other (personal distress). Therefore, we propose that the issue of empathy in AS should be revisited.

Experimental determination of pain sensitivity has received increasing attention because of emerging clinical applications (including prediction of postoperative pain and treatment response) and scientific implications (e.g. it has been proposed that above-average pain sensitivity is a risk factor for the development of chronic pain disorders). However, the use of experimental pain sensitivity assessment on a broad scale is hampered by its requirements on time, equipment and human resources and the fact that it is painful for the tested subject. Alternatives to experimental pain testing are currently lacking. Here we developed a self-rating instrument for the assessment of pain sensitivity, the Pain Sensitivity Questionnaire (PSQ) that is based on pain intensity ratings of daily life situations and takes 5-10min to complete. Adequate reliability of the PSQ was confirmed in 354 subjects. In a validation study comprising 47 healthy subjects, the results of comprehensive experimental pain testing, including different modalities (heat, cold, pressure, and pinprick) and different measures (pain thresholds, pain intensity ratings), were compared to the results of the PSQ. PSQ scores were significantly correlated to experimental pain intensity ratings (r = 0.56, p < 0.001) but not to pain thresholds (r = 0.03). Prediction of experimental pain intensity ratings by the PSQ was better than by pain-associated psychological factors (pain catastrophizing, depression, anxiety). This shows that the PSQ may be a simple alternative to experimental pain intensity rating procedures in healthy subjects and makes the PSQ a highly promising tool for clinical and experimental pain research.

Previous research in social neuroscience has consistently shown that empathy for pain recruits brain areas that are also activated during the first-hand experience of pain. This has been interpreted as evidence that empathy relies upon neural processes similar to those underpinning the first-hand experience of emotions. However, whether such overlapping neural activations imply that equivalent neural functions are engaged by empathy and direct emotion experiences remains to be demonstrated. We induced placebo analgesia, a phenomenon specifically modulating the first-hand experience of pain, to test whether this also reduces empathy for pain. Subjective and neural measures of pain and empathy for pain were collected using self-report and event-related potentials (ERPs) while participants underwent painful electrical stimulation or witnessed that another person was undergoing such stimulation. Self-report showed decreased empathy during placebo analgesia, and this was mirrored by reduced amplitudes of the pain-related P2, an ERP component indexing neural computations related to the affective-motivational component of pain. Moreover, these effects were specific for pain, as self-report and ERP measures of control conditions unrelated to pain were not affected by placebo analgesia. Together, the present results suggest that empathy seems to rely on neural processes that are (partially) functionally equivalent to those engaged by first-hand emotion experiences. Moreover, they imply that analgesics may have the unwanted side effect of reducing empathic resonance and concern for others.Copyright © 2015 the authors 0270-6474/15/358938-10$15.00/0.

Studies of autistic traits in the general population are becoming increasingly prevalent. In this letter to the editor, we caution researchers against framing and interpreting studies of autistic traits in the general population as extending to autism and implore them to be clear about when their study sample does and does not include autistic participants.

Empathy for pain is influenced by several factors, including observer beliefs. This study aimed to test the associations between empathy for pain, fear of pain and health anxiety.

Potential applications of attention bias modification (ABM) for acute and chronic pain patients are investigated. In study 1, 54 acute back pain patients (46 of whom completed the study) were recruited at their initial physiotherapy session and randomised to receive 1 session of ABM or placebo. Patients were followed up 3 months later. Participants who were randomised to receive ABM reported less average (P=0.001) and current pain (P=0.008) and experienced pain for fewer days (P=0.01) than those who received placebo. In study 2, 34 chronic pain patients were recruited and randomly assigned to receive either 4 sessions of ABM (n=22) or placebo (n=12), followed by 8 sessions of cognitive behavioural treatment (CBT). After ABM, there was a significant group-by-time effect for disability. By 6-month follow-up, differences had emerged between the 2 training groups, such that the ABM group had shown greater reductions in anxiety sensitivity and disability than the placebo group. Although the results of these studies show that there is potential in the application of ABM to pain conditions, the mechanisms of treatment could not be established. Neither group showed an initial bias towards the word stimuli or a training effect, and only in the acute pain group were changes in biases related to outcome. Nonetheless, the fact that 2 independent samples showed a positive effect of ABM on clinical outcomes suggests that ABM is worthy of future study as an intervention for pain patients.Copyright © 2011 International Association for the Study of Pain. All rights reserved.

Objectives: Psychometric properties of the Chinese version of the Interpersonal Reactivity Index (C-IRI) for the assessment of empathy in Chinese people were examined. Method: The Interpersonal Reactivity Index (IRI) was translated to Chinese, and an expert panel reviewed its content validity and cultural relevance. The translated instrument (C-IRI) was administered to 189 junior high school students and 391 university students. Results: Confirmatory factor analyses revealed a stable hierarchical three-factor structure that was consistent with structure of the English IRI, but the cognitive and emotional aspects of empathy were combined to form a new factor. The subscales of the C-IRI demonstrated acceptable to good internal consistency and test-retest reliability. Some evidence for the construct validity of the measure was also found. Conclusions: The C-IRI possessed acceptable psychometric properties in Chinese adolescent samples. The present findings suggest that the cognitive and emotional aspects of empathy are not differentiated in Chinese adolescents.

Although empathy has always been considered to be impaired in individuals with autism spectrum conditions (ASCs), the relevant findings have been inconsistent. The present meta-analysis aims to determine which empathy components are impaired and how culture, gender, and age moderate such empathy impairment. By using "Autism," "Asperger Syndrome," "Empathy," and related Chinese synonyms as keywords, we searched the databases of Weipu, Wanfang, CNKI, Web of Science, Science Direct, SpringerLink, and Elsevier through "subject" and "keyword" searches. We also conducted a manual search according to the references. In total, 51 studies from Eastern and Western countries were included in this meta-analysis, which comprised 144 independent effects, 2,095 individuals with ASCs and 2,869 controls without ASCs. For the retrieved data, Hedge's was taken as the quantitative measure of effect, and CMA V2.0 software was used for publication bias tests (by using Rosenthal's Classic Failsafe- and Egger's methods), heterogeneity tests (by using a -test, -test, and -test) and a moderating effect test (by using a univariate regression model). The results showed that the empathy impairment evident in individuals with ASCs is component specific; that is, trait-cognitive empathy, trait-empathic concern, state-cognitive empathy, and state-empathic concern are impaired, whereas state-empathic accuracy remains intact, and trait-empathic accuracy is superior to the trait-empathic accuracy in neurotypical individuals. The univariate regression model showed that gender moderates the impairment of the trait-empathic concern, trait-empathic accuracy, and state-cognitive empathy in autistic individuals and that age moderates the impairment of the trait-cognitive empathy, trait-empathic accuracy, state-empathic concern, and state-empathic accuracy in autistic individuals. However, culture does not moderate any empathy components (trait-cognitive empathy, trait-empathic concern, or state-cognitive empathy) involved in the present meta-analysis. These findings contribute to ending the controversy over the empathic integrity of individuals with ASCs and shed some light on future research about the empathy impairment of autistic individuals. More specifically, subsequent studies should distinguish specific empathy components and consider the role of gender and age when demonstrating empathy impairment in individuals with ASCs. Moreover, related studies based on Asian collectivist cultural samples and female samples should be further enriched.Copyright © 2019 Song, Nie, Shi, Zhao and Yang.

Diagnosis, intervention and support for people with autism can be assisted by research into the aetiology of the condition. Twin and family studies indicate that autism spectrum conditions are highly heritable; genetic relatives of people with autism often show milder expression of traits characteristic for autism, referred to as the Broader Autism Phenotype (BAP). In the past decade, advances in the biological and behavioural sciences have facilitated a more thorough examination of the BAP from multiple levels of analysis. Here, the candidate phenotypic traits delineating the BAP are summarised, including key findings from neuroimaging studies examining the neural substrates of the BAP. We conclude by reviewing the value of further research into the BAP, with an emphasis on deriving heritable endophenotypes which will reliably index autism susceptibility and offer neurodevelopmental mechanisms that bridge the gap between genes and a clinical autism diagnosis.

Past research has shown that pain catastrophizing contributes to heightened pain experience. The hypothesis advanced in this study was that individuals who score high on measures of pain catastrophizing would also perceive more intense pain in others. The study also examined the role of pain behaviour as a determinant of the relation between catastrophizing and estimates of others' pain. To test the hypothesis, 60 undergraduates were asked to view videotapes of individuals taking part in a cold pressor procedure. Each individual in the videotapes was shown three times over the course of a 1min immersion such that the same individual was observed experiencing different levels of pain. Correlational analyses revealed a significant positive correlation between levels of pain catastrophizing and inferred pain intensity, r=.31, p<.01. Follow-up analyses indicated that catastrophizing was associated with a heightened propensity to rely on pain behaviour as a basis for drawing inferences about others' pain experience. Catastrophizing was associated with more accurate pain inferences on only one of three indices of inferential accuracy. The pattern of findings suggests that increasing reliance on pain behaviour as a means of inferring others' pain will not necessarily yield more accurate estimates. Discussion addresses the processes that might underlie the propensity to attend more to others' pain behaviour, and the clinical and interpersonal consequences of perceiving more pain in others.

Screening for autism in individuals with generalized social anxiety disorder (GSAD) is complicated by symptom overlap between GSAD and autism spectrum disorder (ASD). We examined the prevalence of self-reported autistic traits within a sample of participants with a diagnosis of GSAD (n=37) compared to individuals without a GSAD diagnosis (NOSAD; n=26). Of the GSAD sample participants, 70.84% self-reported autistic traits above a cut-off of 65 on the Autism Quotient-Short (AQ-S) and reported significantly more autistic traits on 3 of 5 AQ-S subscales compared to the NOSAD group. Diagnosis uniquely predicted variation in the social skills subscale above and beyond the other subscales and other predictors. Furthermore, variation in the social skills subscale largely explained group differences on the other subscales. Our results suggest caution in utilizing measures like the AQ-S with clinical populations characterized by social difficulties such as individuals with a GSAD diagnosis. Copyright © 2015 Elsevier Ltd. All rights reserved.

Pain is a complex, multidimensional experience that has defied our understanding for centuries. Through the advent of noninvasive neuroimaging techniques, we have been able to examine the human brain and its response to nociceptive inputs. As a result, our knowledge of which brain regions are critical for generating an acute pain experience has grown, as has our understanding of how cognitive, emotional, contextual and various physiological factors influence the pain experience. Furthermore, we have been able to identify key processes within the brain that underpin the transition to and maintenance of chronic pain states, as well as highlight the dramatic consequences of chronic pain on the brain's structure and neurochemistry. Building upon this knowledge, we are now in a position to consider whether any of these brain imaging 'phenotypes' of acute or chronic pain should be considered as useful endophenotypes; thereby enabling us to relate the complex genetics that underpin everyday pain sensitivity or chronic pain states to intermediate biomarkers. This endophenotypic approach-the focus of this Review-simplifies the connection between genes and behavior and is needed for complex disorders like chronic pain.

Intolerance of uncertainty (IU) is a dispositional risk factor involving maladaptive responding under conditions of uncertainty. Recent data indicate that IU is likely elevated in youth with autism spectrum disorder (ASD) and is positively correlated with anxiety. This study examined whether IU may be associated with ASD independent of anxiety. Relationships between anxiety, ASD, and IU were examined in 57 children with ASD without co-occurring intellectual disability and 32 control participants, ages 7-16 years. Hierarchal linear regressions were run to examine whether ASD variables, including emotion dysregulation, were predictive of IU when controlling for anxiety. Severity of social communication deficits, repetitive behaviors, and emotion dysregulation were each related to IU when controlling for the effects of anxiety. When these variables were entered into the regression model together, emotion dysregulation was the only significant predictor of IU. These findings suggest that IU is directly related to features of ASD possibly due to shared genetic, neurological, or psychological underpinnings. Autism Res 2018, 11: 636-644. © 2018 International Society for Autism Research, Wiley Periodicals, Inc.Youth with ASD without co-occurring intellectual disability experience high levels of intolerance of uncertainty (IU), which is related to anxiety. This study found that IU may also have a relationship with certain aspects of ASD, particularly emotion dysregulation.© 2018 International Society for Autism Research, Wiley Periodicals, Inc.

The perception of pain is sensitive to various mental processes such as the feelings and beliefs that someone has about pain. It is therefore not exclusively driven by the noxious input. Attentional modulation involving the descending pain modulatory system has been examined extensively in neuroimaging studies. However, the investigation of neural mechanisms underlying more complex cognitive modulation is an emerging field in pain research. Recent findings indicate an engagement of the ventrolateral prefrontal cortex during more complex modulation, leading to a change or reappraisal of the emotional significance of pain. Taking placebo-induced analgesia as an example, we discuss the contribution of attention, expectation and reappraisal as three basic mechanisms that are important for the cognitive modulation of pain.

Fear of pain plays a crucial role in the development and maintenance of chronic pain. Fear of pain appears to have a key role in early stage of attention processing towards pain-related information across different types of stimuli and groups. Considerable evidence indicates associated attention biases reflect hypervigilance that may contribute to perpetuating the focus on pain and interfere with the capacity to attend to non-painful experiences. Modifying attention biases related to fear of pain has the potential to improve pain experience. Future research should use tasks with more ecological validity to investigate information- processing related to fear of pain and its neural substrates. In addition, more research is needed to explore how effective different attention modification strategies are in reducing distress and disability among chronic pain patients.

疼痛恐惧是影响和维持慢性痛的重要因素。不同材料和被试类型情况下, 疼痛恐惧均主要作用于个体对疼痛相关信息的早期注意加工阶段, 表现为注意警觉模式。该注意模式使个体将注意维持在疼痛上, 从而干扰了对非疼信息的注意能力。矫正疼痛恐惧相关注意偏向可以改善疼痛体验。未来研究应采用更具生态效度的任务测量疼痛恐惧相关的注意偏向及其神经基础, 进一步考察矫正疼痛恐惧相关注意偏向能否改善慢痛患者的忧郁和功能丧失等问题。

Many studies have shown effects of anodal transcranial direct current stimulation (a-tDCS) and high-frequency transcranial random noise stimulation (tRNS) on elevating cortical excitability. Moreover, tRNS with direct current (DC)-offset is more likely to lead to increases in cortical excitability than solely tRNS. While a-tDCS over primary motor cortex (M1) has been shown to attenuate pain perception, tRNS with DC-offset may prove as an effective means for pain relief.This study aimed to examine effects of a-tDCS and high-frequency tRNS + DC-offset over M1 on pain expectation and perception, and assess whether these effects could be influenced by the certainty of pain expectation.Using a double-blinded and sham-controlled design, 150 healthy participants were recruited to receive a single-session a-tDCS, high-frequency tRNS + DC-offset, or sham stimulation over M1. The expectation and perception of electrical stimulation in certain and uncertain contexts were assessed at baseline, immediately after, and 30 min after stimulation.Compared with sham stimulation, a-tDCS induced immediate analgesic effects that were greater when the stimulation outcome was expected with uncertainty; tRNS induced immediate and sustained analgesic effects that were mediated by decreasing pain expectation. Nevertheless, we found no strong evidence for tRNS being more effective for attenuating pain than a-tDCS.The analgesic effects of a-tDCS and tRNS showed different temporal courses, which could be related to the more sustained effectiveness of high-frequency tRNS + DC-offset in elevating cortical excitability. Moreover, expectations of pain intensity should be taken into consideration to maximize the benefits of neuromodulation.Copyright © 2021. Published by Elsevier Inc.

This study was conducted to examine the psychometric properties of a Chinese translation of the Pain Catastrophizing Scale (HK-PCS).Patients aged 18-79 years (N = 130) with chronic nonmalignant pain attending an outpatient multidisciplinary pain center in Hong Kong participated in this cross-sectional study.Subjects completed a set of health-related instruments: HK-PCS, Hospital Anxiety and Depression Scale, Roland Morris Disability Questionnaire, SF-36 Health Survey, and a general demographic questionnaire. Data were analyzed for the distribution, internal consistency, reliability, and construct validity.A satisfactory internal consistency was found (alpha = 0.927). The item-total correlation coefficients ranged from 0.575 to 0.777. The intraclass correlation coefficient was 0.969 for the total HK-PCS score, 0.956 for helplessness, 0.945 for magnification, and 0.910 for rumination. Confirmatory factor analysis verified a second-order factor structure with the comparative fit index = 1.00, root mean square error of approximation = 0.038, and normed fit index = 0.99 (chi(2) ((58)) = 68.84, P = 0.16). Significant correlations were found for pain intensity, disability, anxiety, and depression (r = 0.223-0.597, P < 0.01). The general health, social function, role emotional, and mental health domains of the SF-36 consistently demonstrated negative association with catastrophizing across all HK-PCS scores (r =-0.279 to -0.396, P < 0.01). No gender difference was noted for HK-PCS scores (P > 0.05), which is contrary to the existing literature.This study has illustrated satisfactory psychometric properties of the HK-PCS. We provide evidence for the validity and reliability of the HK-PCS as an instrument for measuring pain catastrophizing in the Chinese patient with chronic pain.

<p id="p00005">Pain is defined as an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage. Pain is of vital functional significance, as it signals threat and initiates behavioral adaptations to avoid harm so as to protect the body. Previous studies have shown abnormalities in pain sensitivity among individuals with autism spectrum disorder (ASD), which have been associated with their clinical core symptoms, including restricted and repetitive behaviors as well as deficits in social behaviors. Evidence from case studies and surveys suggested the hyposensitivity to pain for individuals with ASD. Nevertheless, results from experimental studies that involved the application of noxious stimulations and psychophysical measurements were heterogeneous, e.g., some studies reported hypersensitivity to pain in ASD individuals, others reported their hyposensitivity or even normal sensitivity to pain. </p> <p id="p00010">These results suggest that the abnormalities of pain sensitivity among individuals with ASD were modality-dependent, with the abnormality selectively applicable to pressure pain or medical pain. Future studies should combine behavioral, physiological, and neuroimaging measures to comprehensively investigate the pain sensitivity profiles of individuals with ASD. The potential link between pain sensitivity and clinical core symptoms among individuals with ASD should be characterized. Relevant results would potentially expand our understanding of ASD neurobiological mechanisms and provide the theoretical basis for pain assessment among individuals with ASD.</p> <p id="p00015">In this study, we utilized a meta-analysis approach to systematically review experimental studies that investigated pain sensitivity among individuals with ASD and were published before August 10, 2020. The meta-analysis was performed according to the rigorous PRISMA Protocol. Studies were included in the analysis if they included both clearly diagnosed ASD individuals and healthy controls, reported data relevant to pain sensitivity, including pain threshold, pain tolerance, pain ratings, and pain-evoked physiological responses. Relevant studies were obtained from databases including China National Knowledge Infrastructure, Web of Science, PsycInfo, and PubMed by searching for keywords including pain, nociception, autis*, and Asperger. The meta-analysis was conducted in STATA 12, and the effect size<i>Hedge's g</i> with ±95% confidence intervals (CIs) was calculated using a random effect statistical model. Further, we assessed possible moderating effects from variables of pain modality, pain site, the age of involved participants, the sample size of the ASD group and sample locations. </p> <p id="p00020">Sixteen experimental studies were included in the meta-analysis, with a total sample size <i>N</i> = 822. Pain threshold was not significantly different between ASD individuals and healthy controls (<i>g</i> = 0.34, 95% CI = [-0.14, 0.82]), and this estimate was moderated by variables of pain modality, the age of involved participants, and the sample size of the ASD group. Specifically, individuals with ASD exhibited lower pain thresholds than those of healthy controls selectively for pressure pain (<i>g</i> = 1.62, 95% CI = [0.46, 2.77]). For the outcome variable of pain evoked physiological response, individuals with ASD showed significantly greater physiological responses to medical procedures than those of healthy controls (<i>g</i>= 2.87, 95% CI = [1.07, 4.67]). Nevertheless, ASD and control groups had comparable pain ratings (<i>g</i> = -0.26, 95% CI = [-0.64, 0.11]). </p>

本研究采用元分析方法, 以疼痛阈限、疼痛诱发生理反应和疼痛评分为结果变量, 考察了自闭症谱系障碍个体(Autism Spectrum Disorder, ASD)的疼痛敏感性异常, 以期为ASD的诊断和干预提供参考。元分析共纳入16项研究(总样本量N = 822)。对于疼痛阈限, ASD组和对照组无显著差异, 但受到疼痛模态等变量的调节作用, 如ASD组的压力疼痛阈限显著低于对照组。对于疼痛诱发生理反应, ASD组对现实医疗疼痛的生理反应强于对照组。然而, ASD组和对照组在疼痛评分上无显著差异。将来研究应结合多模态疼痛刺激和多维度疼痛评估, 系统考察ASD个体的疼痛敏感性及其与临床核心症状之间的联系。

Although the core characteristics associated with autistic traits are impaired social interactions, there are few studies examining how autistic traits translate into prosocial behaviour in daily life. The current study explored the effect of autistic traits on prosocial behaviour and the mediating role of multimodal empathy (trait empathy and state empathic concern). The results showed that autistic traits reduced prosocial behaviour directly and indirectly through complex mediation by multimodal empathy. The findings revealed the internal mechanism of autistic traits impeding prosocial behaviour and expanded our understandings of social behaviour in autism spectrum conditions (ASCs) and autistic traits in the general population. Furthermore, the results have implications for social adaptability interventions for individuals with ASCs and high levels of autistic traits.

Placebo effects benefit a wide range of clinical practice, which can be profoundly influenced by expectancy level and personal characteristics. However, research on the issue of whether these factors independently or interdependently affect the placebo effects is still in its infancy. Here, we adopted a 3-day between-subject placebo analgesia paradigm (2-day conditioning and 1-day test) to investigate the influence of expectancy levels (i.e., No, Low, and High) and personal characteristics (i.e., gender, dispositional optimism, and anxiety state) on placebo effects in 120 healthy participants (60 females). Our results showed that the reduction of pain intensity in the test phase was influenced by the interaction between expectancy and gender, as mainly reflected by greater reductions of pain intensity in females at Low expectancy level than females at No/High expectancy levels, and greater reductions of pain intensity in males than in females at High expectancy level. Additionally, the reduction of pain unpleasantness was not only modulated by the interaction between expectancy and gender, but also by the interaction between expectancy and dispositional optimism, as well as the interaction between expectancy and anxiety state. Specifically, participants who were more optimistic in Low expectancy group, or those who were less anxious in High expectancy group showed greater reductions of pain unpleasantness. To sum up, we emphasized on regulating the expectancy level individually based on the assessment of personal characteristics to maximize placebo effects in clinical conditions.

Reduced empathy and alexithymic traits are common across the autism spectrum, but it is unknown whether this is also true for intellectually advanced adults with autism spectrum disorder. The aim of this study was to examine whether college students with autism spectrum disorder experience difficulties with empathy and alexithymia, and whether this is associated with their cognitive levels of executive functioning. In total, 53 college students with autism spectrum disorder were compared to a gender-matched group of 29 neurotypical students on cognitive and affective dimensions of empathy and alexithymia. In addition, cognitive performance on executive functioning was measured with computerized and paper-and-pencil tasks. The autism spectrum disorder group scored significantly lower on cognitive empathy and higher on cognitive alexithymia (both  = 0.65). The difference on cognitive empathy also remained significant after controlling for levels of cognitive alexithymia. There were no group differences on affective empathy and alexithymia. No significant relations between executive functioning and cognitive alexithymia or cognitive empathy were detected. Together, these findings suggest that intellectually advanced individuals with autism spectrum disorder experience serious impairments in the cognitive processing of social-emotional information. However, these impairments cannot be attributed to individual levels of cognitive executive functioning.